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PoAC Application
PoAC Application
GOVERNMENT OF INDIA
INDIA POST
Application for Proof of Address Card
Please write the BLOCK LETTERS
1. Name of the applicant:
1(a). Nationality
2. Name of Father / Husband / Parent / Guardian / Other Relative (Please mention relationship):
Please affix
recent
stamp size
colour
photograph
5. Permanent Postal Address with PIN Code (if different from serial 4):
7. If you are a tenant, please furnish particulars (address / telephone number / mobile number / email id) of the landlord or flat / apt owner's association:
8. Particulars of Employment identity (if employed), Please attach photo copy of ID card issued by the employer:
Mobile Number
Blood Group
9
Personal marks of identification
11. Have you applied for Proof of Address Card from India Post earlier? :
12. Fee prescribed :
Yes
No
Certified that the information furnish ed above is true to the b est of my knowledge. The Proof of reside nce
card issued on the basis of this ap plication imposes no legal liability on Ind ia Post.
Place : _______________________
Date : _______________________
Receipt No.
Date
For Rupees
2 5 0
Serial number of Proof of Address Card issued
1 5 0
Date of Issue
1 0 0
Date of issue
Place : _______________________
Date : _______________________
ONLINE APPLICATION
Please affix
recent
stamp size
colour
photograph
Mobile Number
6. Blood Group:
9
(FOR OFFICE USE ONLY)
7. Name of the Head Post Office with PIN Code:
CHIEF POSTMASTER
SENIOR POSTMASTER
HEAD POSTMASTER
11. Signature of the Issuing Authority (please sign within the box):